For centuries, the infestation of wounds by certain species of fly larvae or maggots has been recognized to debride, to enhance healing, and to decrease the mortality associated with the underlying injury. The practice of using maggots to treat bone and soft tissue infections was employed commonly by surgeons in North America during the 1930s and 1940s. The past 20 years have seen resurgence in the successful use of maggot debridement therapy for treating such afflictions as pressure ulcers, venous stasis ulcers, temporal mastoiditis, Fournier's gangrene, necrotizing tumor masses, and other soft tissue wounds that have not responded favorably to more conventional modalities.
The maggot debridement therapy dressings of 60 years ago were quite elaborate, expensive, and time-consuming to construct. Maggot debridement therapy dressings often consisted of either a maggot-filled cloth bag with its edges plastered to the wound margins or else an elaborate copper-mesh cage taped to the skin. Glass tubing sometimes was placed into a deep sinus in order to facilitate drainage and to prevent the top of the hole from closing prematurely.
During the 1970s and 1980s, a common maggot debridement therapy dressing included a simple gauze wrap over the maggot-laden wound. The nature of maggots, though, is that they will wander at will, and they will leave a wound once it is no longer nourishing or no longer necrotic. The maggots also will leave their food source when they are fully mature and attempt to seek an appropriate location for the pupation process which is the next stage in their metamorphosis into an adult fly. Gauze will not provide a sufficient barrier to their escape in any of these situations.
What has been needed are dressings for maggot debridement therapy that are inexpensive and convenient to apply. What has also been needed are dressings that are simple to maintain, durable enough to last throughout a therapeutic application period. What has also been needed are dressings that make the application of maggots and the confinement of maggots to a patient's wound site convenient and reliable.